Gasowska-Bodnar Agnieszka, Bodnar Lubomir, Wcisło Gabriel Benedykt, Jerzak Małgorzata Maria, Szczylik Cezary, Baranowski Włodzimierz
Klinika Ginekologii i Ginekologii Onkologicznej, Wojskowy Instytut Medyczny, Warszawa.
Ginekol Pol. 2008 Feb;79(2):108-14.
The aim of our study was to assess the prognostic role of CA 125 regression during neoadjuvant chemotherapy (NAC) in patients with ovarian cancer (OC) or primary peritoneal serous carcinoma (PPSC) that underwent interval debulking surgery (IOC).
Thirty one patients with advanced OC or PPSC (FIGO stage IIIC and IV) who underwent initial exploratory surgery, followed by NAC containing platinum analogs, have been analyzed, retrospectively. We have used a regression coefficient (RCA 125), which was calculated as following: log10 (CA 125 level measured after two cycles of NAC/baseline CA 125) for statistical analysis. The median value of RCA 125 reached -0.788 and has been used to dichotomize. Optimal IOC has been performed in 67.74% (21/31) patients, suboptimal in 25.81% (8/31) patients and 6.45% (2/31) of patients did not undergo IOC due to the progression of the disease.
We have noted significant correspondence between time to progression and RCA 125 in univariate analysis, which we have also confirmed in multivariate analysis (HR 0.27; 95% CI, 0.15-0.96; p = 0.0178). Similarly, we have observed significant relationship between overall survival, RCA 125 and extension IOC in univariate analysis. Multivariate analysis confirmed that RCA 125 was independent prognostic factor, HR-0.18 (95% CI, 0.07-0.56; p = 0.004). In case of patients with high RCA 125, a greater rate of optimal debulking cytoreduction (p = 0.0278, U = 50.0) has been observed.
RCA 125 after two courses of NAC appears to be an important prognostic factor in patients with OC or PPSC, who underwent IOC High RCA 125 during NAC seems to be a good predictive factor in order to achieve optimal IOC.
我们研究的目的是评估在接受间歇性肿瘤细胞减灭术（IOC）的卵巢癌（OC）或原发性腹膜浆液性癌（PPSC）患者中，新辅助化疗（NAC）期间CA 125消退的预后作用。
对31例晚期OC或PPSC（国际妇产科联盟（FIGO）分期IIIC和IV期）患者进行回顾性分析，这些患者先接受了初步探查手术，随后接受含铂类药物的NAC。我们使用了一个回归系数（RCA 125），其计算方法如下：log10（NAC两个周期后测得的CA 125水平/基线CA 125）用于统计分析。RCA 125的中位数达到-0.788，并用于二分法分析。67.74%（21/31）的患者进行了最佳IOC，25.81%（8/31）的患者进行了次优IOC，6.45%（2/31）的患者因疾病进展未接受IOC。
我们在单因素分析中发现疾病进展时间与RCA 125之间存在显著相关性，在多因素分析中也得到了证实（风险比（HR）0.27；95%置信区间（CI），0.15 - 0.96；p = 0.0178）。同样，我们在单因素分析中观察到总生存期、RCA 125与IOC范围之间存在显著关系。多因素分析证实RCA 125是独立的预后因素，HR为-0.18（95%CI，0.07 - 0.56；p = 0.004）。在RCA 125高的患者中，观察到最佳肿瘤细胞减灭术的比例更高（p = 0.0278，U = 50.0）。
两疗程NAC后的RCA 125似乎是接受IOC的OC或PPSC患者的一个重要预后因素。NAC期间高RCA 125似乎是实现最佳IOC的一个良好预测因素。
